Vein Sclerotherapy Phlebology, vein treatment

NON-SURGICAL REMOVAL OF VASCULAR SPIDERS AND GRIDS ON THE LEGS

Varicose veins today have become a pretty common problem. This disease is not only an aesthetic drawback, but over time can lead to the development of serious complications (edema, thrombophlebitis, trophic ulcers, deep vein thrombosis and thromboembolism).

Vein sclerotherapy is a modern non-surgical method for the treatment of varicose disease of the lower extremities. The procedure allows you to get rid of vascular spiders and grids on the legs, as well as varicose veins in the initial stages with the help of point injections of sclerosant.

Sclerotherapy allows selective removal of varicose veins, while maintaining healthy areas of the blood vessels.

About the method

Sclerotherapy (phleboscleroobliteration) is the effect on the inner shell of the venous wall of a special substance – sclerosant, resulting to its damage, followed by gluing the walls and turning the vein into a gapless connective tissue tube (strand).

After exposure of the sclerosant, the thin connective tissue strand is formed within 2-6 months, then it undergoes resorption and completely disappears in 1-1.5 years.

Sclerotherapy involves medication treatment as well. Intake of drugs is necessary to improve the tone of the lymphatic and venous vessels. The most commonly prescribed drugs are from the group of venotonics and angioprotectors.

Sclerosants, drugs for sclerotherapy (phlebosclerosants)

Phlebosclerosis drugs (or sclerosants) are specially developed substances intended for intravenous administration, causing destruction of the inner (endothelial) vein layer and its significant narrowing, which creates conditions for scleroobliteration (gluing) and complete closure of the venous vessel.

Sclerotherapy Advantages

• Sclerotherapy involves the use of clinically researched drugs from reputable foreign manufacturers.
• Sclerotherapy does not involve cuts. This is an injection procedure – there are no scars after the treatment.
• Sclerotherapy is the least traumatic method of treating varicose veins; it does not require anesthesia, since the thinnest, especially sharpened needles are used.
• Instant result for 1 day. For injections, hospitalization and anesthesia are not required.

Indications

• Vascular spiders and grids. The main indication for sclerotherapy is reticular varicose veins, the manifestations of which are commonly referred to as vascular grids and spiders. This is the best way to treat such a vascular pathology.
• Scattered varicose veins. When surgery is complicated.
• Varicose at the initial stage. Sclerotherapy gives good results in the treatment of the initial stages of varicose dilatation, when there is no need for surgery or that has arisen after surgical removal of veins
• Period after surgical treatment of varicose veins. Sclerotherapy is performed as an additional method after surgical treatment of varicose veins, both after phlebectomy (plastic surgery aimed at eliminating varicose veins) and after endovenous (laser) interventions. Performing sclerotherapy enhances the effect of surgical treatment and is a very important way to prevent recurrence of the disease, as well as provides a better aesthetic effect.

Result

• Improves blood circulation in the legs;
• Eliminates abnormal blood stasis in varicose veins and the further progress of the disease.
• Eliminates clinical manifestations of varicose disease: pain, swelling, convulsions, fatigue.
• Vascular spiders disappear, veins become less noticeable.

In one session, you can affect several foci of pathology, which speeds up and improves the effect. Vascular spiders completely disappear after 2-3 weeks of therapy; varicose veins disappear after 1-3 months.

Absolute contraindications for sclerotherapy

• Pregnancy and lactation;
• Individual intolerance to sclerosants (drugs for sclerotherapy), polyvalent allergy (increased sensitivity of the body to several types of allergens simultaneously);
• When varicose veins are accompanied by insufficiency of communicant and main trunk vein valves;
• Deep vein thrombosis and thrombophlebitis of the superficial veins of the lower extremities;
• Severe systemic diseases (cardiopulmonary insufficiency, hepatorenal insufficiency);
• Local or general infection;
• Presence of purulent-inflammatory foci on the skin of the legs;
• Impossibility of controlled intravascular injections.

Sclerotherapy may be restricted to use in the following situations

• Obesity. Obesity creates objective difficulties for the imposition of an adequate compression bandage, which reduces the effectiveness of treatment and increases the risk of possible complications, can create the impossibility of controlled intravascular injections. Obesity is a significant risk factor for venous insufficiency and chronic vein diseases, therefore the overall effectiveness of the treatment of varicose veins is reduced.

• Taking of hormonal drugs (hormonal contraception and hormone replacement therapy). Synthetic sex hormone analogs are risk factors for thrombophlebitis, skin hyperpigmentation and neovascularization. The best option is the abolition of hormonal drugs for 1.5 – 2 months before sclerotherapy, and the resumption of their reception no earlier than 3 months after the end of treatment.

• Planning a pregnancy. Not recommended for women who are planning a pregnancy in the next 1-1.5 years due to the high probability of recurrence of varicose veins.

• Previous treatment of alcoholism. All sclerosing drugs approved for use in the EU are made on the basis of alcohols, therefore it is not recommended to use them in people who have been treated for alcohol dependence.

• The hot season. High air temperature causes significant discomfort when wearing the compression band, while excessive insolation can worsen the aesthetic result of treatment.

• Psychological ill-preparedness of the patient. The patient should understand that sclerotherapy is not the most radical method of treatment and most often may require a repetition of the procedure or surgical treatment in a few years.

• Unclosed oval window. An unclosed oval window is a developmental anomaly found in 15-25% of the European population, which is a relative contraindication to foam sclerotherapy due to the possibility of airborne cerebral embolism with transient neurological disorders and the possibility of a persistent neurological deficit in casuistic cases. At the same time, sclerotherapy with liquid forms of drugs is not contraindicated.

Recommendations before sclerotherapy of lower extremity veins

• The optimal time for sclerotherapy is autumn, winter and early spring. In the cold season, infections spread more slowly and it is easier to wear tight compression knitwear.
• Before sclerotherapy, it is necessary to do laboratory tests: complete blood and urine analysis, biochemical blood analysis, ultrasound examination of veins and an allergic test, which allows to exclude an immune response to sclerosant.
• 2 days before the procedures, it is necessary to refrain from alcohol, smoking and any cosmetic procedures (epilation and waxing).

Care after sclerotherapy of lower extremity veins

• After the procedure, it is recommended to walk about 30-40 minutes. This accelerates the displacement of blood from the vein and facilitates the collapse of the vessel (it becomes invisible);
• In the future, avoid prolonged sitting or standing position;
• It is necessary to limit physical activity for 1 week after the procedure;
• Exclude use of the sauna or bath for 2 months;
• Within 2-3 days after sclerotherapy, the compression should be round-the-clock – stockings should be worn day and night. After this period, hospital stockings should be worn for another 2-3 months, and only during the daytime.
• To avoid the recurrence of varicose veins, long-term prophylactic compression may be required. For this purpose, apply everyday compression knitwear.

Treatment course

To avoid overdosing of the drug and circulatory disorders, vein sclerosing in the legs is carried out in several stages (1-5 procedures depending on the severity of the disease), at intervals of 7 days. For the next 7 days, constant compression is important.

The duration of treatment and the number of procedures are determined by the phlebologist on the basis of the diagnosis of the disease, its form and severity, and the general condition of the body, who necessarily takes into account the general health and taking any hormonal or anti-inflammatory drugs.

Compression therapy

Compression therapy is required for all forms of varicose veins. Compression knitwear has 4 classes and differ in the degree of elongation, which knitwear to use is determined by the phlebologist.

Before and After Photos

Prior to the injection, a consultation with a phlebologist is mandatory.

The procedure is being conducted by Dr. Viacheslav Moisejenko